Insurance Specialist

3 weeks ago

Wheeling, United States WVU Medicine Full time
Welcome We're excited you're considering an opportunity with us To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position.

This position responsible for assuring all appointments and procedures are authorized. Insurance carriers are contacted to verify coverage and benefit limitations, tests and procedures are pre-authorized and scheduled, deductibles, co-payments, account balances, and fees are calculated and notations are added to the system for front end collection. Responsible for minimizing reimbursement errors resulting from inaccuracy of referral and enrollment information.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. High school diploma or equivalent.
2. West Virginia state criminal background check required, and Federal, if applicable, for DHHR BMS regulated area.

PREFERRED QUALIFICATIONS:

EXPERIENCE:
1. Previous insurance authorization experience.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Identifies all patients requiring pre-certification or pre-authorization at the time services are requested or when notified by another hospital or clinic department.
2. Follows up on accounts as indicated by system flags.
3. Contacts insurance company or employer to determine eligibility and benefits for requested services.
4. Follows up with the patient, insurance company or provider if there are insurance coverage issues in order to obtain financial resolution.
5. Use work queues within the EPIC system for scheduling, transition of care, and billing edits.
6. Performs medical necessity screening as required by third party payors.
7. Documents referrals/authorization/certification numbers in the EPIC system.
8. Initiates charge anticipation calculations. Accurately identifies anticipated charges to assure identification of anticipated self-pay portions.
9. Communicates with the patient the anticipated self-pay portion co-payments/deductibles/co-insurance, and account balance refers self-pay, patients with limited or exhausted benefits to the in-house Financial Counselors to determine eligibility.
10. Assists Patient Financial Services with denial management issues and will appeal denials based on medical necessity as needed.
11. Communicates problems hindering workflow to management in a timely manner.
12. Assesses all self-pay patients for potential public assistance through registration/billing systems Provides self-pay/under-insured patients with financial counseling information. Maintains current knowledge of major payor payment provisions.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Prolonged periods of sitting.
2. Extended periods on the telephone requiring clarity of hearing and speaking.
3. Manual dexterity required to operate standard office equipment.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Standard office environment.

SKILLS AND ABILITIES:

1. Excellent oral and written communication skills.
2. Basic knowledge of medical terminology.
3. Basic knowledge of ICD-10 and CPT coding, third party payors, and business math.
4. General knowledge of time of service collection procedures.
5. Excellent customer service and telephone etiquette.
6. Minimum typing speed of 25 works per minute.
7. Must have reading and comprehension ability.

Additional Job Description:

Scheduled Weekly Hours:
40

Shift:

Exempt/Non-Exempt:
United States of America (Non-Exempt)

Company:
WVUH West Virginia University Hospitals

Cost Center:
500 WH Administration

Address:
1 Medical Park Drive

Wheeling

West Virginia

WVU Medicine is proud to be an Equal Opportunity employer. We value diversity among our workforce and invite applications from all qualified applicants regardless of race, ethnicity, culture, gender, sexual orientation, sexual identity, gender identity and expression, socioeconomic status, language, national origin, religious affiliation, spiritual practice, age, mental and physical ability/disability or Veteran status.

  • Insurance Specialist

    4 weeks ago

    Wheeling, West Virginia, United States Jessica Hoskinson - State Farm Agent Full time

    Job DescriptionAs a dedicated Insurance Specialist with Jessica Hoskinson - State Farm Agent, you will play a vital role in supporting insurance agents in gaining and keeping customers. Your attention to detail, dedication to client relations, and sales-mindedness will equip you for this versatile position. Your contributions as a motivated professional who...

  • Insurance Specialist

    3 weeks ago

    Wheeling, West Virginia, United States WVU Medicine Full time

    Job Summary: We are seeking an Insurance Specialist to join our team at WVU Medicine. The successful candidate will be responsible for ensuring all appointments and procedures are authorized, verifying coverage and benefit limitations, and communicating with patients and insurance companies to resolve any issues.Key Responsibilities:Identify patients...

  • Insurance Specialist

    3 weeks ago

    Wheeling, United States WVU Medicine Full time

    Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position. This position responsible for assuring all appointments and procedures are authorized....

  • Commercial Lines New Business Marketing Specialist Team Lead

    5 months ago

    Wheeling, United States USI Insurance Services Full time

    General Description: Manage the operational activities of the New Business Regional Marketing Specialist unit/department. Actively market new prospective client accounts to carrier partners. Support commercial lines sales associates. Provide marketing analytics, negotiate carrier coverages, and finalize marketing and client onboarding process. **This...

  • Diagnostic Imaging Specialist

    4 weeks ago

    Wheeling, West Virginia, United States Cavalier Mobile X-ray Inc Full time

    Job SummaryCavalier Mobile X-ray Inc is seeking a skilled Diagnostic Imaging Specialist to join our team. As a Diagnostic Imaging Specialist, you will be responsible for performing diagnostic radiographic examinations in a mobile environment. This is a unique opportunity to work with a leading company in the industry and contribute to the delivery of...

  • RN - Telemetry/PCU Specialist

    4 weeks ago

    Wheeling, West Virginia, United States White Glove Placement Full time

    Job Title: RN - Telemetry/PCU SpecialistJob Summary: We are seeking a skilled RN - Telemetry/PCU Specialist to join our team at White Glove Placement. As a RN - Telemetry/PCU Specialist, you will be responsible for providing high-quality patient care in a dynamic and fast-paced environment.Responsibilities:Provide direct patient care to patients in the...

  • Accounting Specialist

    2 months ago

    Wheeling, United States LHH Recruitment Solutions Full time

    Job DescriptionJob DescriptionLHH Recruitment Solutions is partnering with a company in the northwest suburbs to assist with a search for an accounting specialist. The accounting specialist will handle both accounts payable and receivable. This is a temporary to possible permanent role and will be located onsite. Preparing and sending out...

  • Grants Specialist

    1 month ago

    Wheeling, United States Youth Services System Full time

    Job DetailsJob LocationHazel Atlas - Wheeling, WVPosition TypeFull TimeEducation Level4 Year DegreeTravel PercentageNoneJob ShiftDayDescriptionJob Summary: The Grant Specialist is part of the Administrative Team and responsible for working closely with the CEO and the CFO in forecasting agency programmatic and capital needs that align with our agency...

  • Aviation Life Support Equipment Specialist

    4 weeks ago

    Wheeling, West Virginia, United States Army National Guard Units Full time

    Job Title: Aviation Life Support Equipment SpecialistJoin the Army National Guard Units as an Aviation Life Support Equipment Specialist and play a vital role in ensuring the safety and success of our pilots and aircrew members. As a member of our team, you will be responsible for inspecting, testing, and maintaining a wide range of aircraft survival...

  • Grants Specialist

    2 months ago

    Wheeling, United States Youth Services System Full time

    Job DetailsJob Location Hazel Atlas - Wheeling, WV Position Type Full Time Education Level 4 Year Degree Travel Percentage None Job Shift Day DescriptionJob Summary: The Grant Specialist is part of the Administrative Team and responsible for working closely with the CEO and the CFO in forecasting agency programmatic and capital needs that align with our...

  • Maintenance Specialist

    4 weeks ago

    Wheeling, West Virginia, United States Wheeling Linen Service, Inc. Full time

    Job SummaryWe are seeking a skilled Maintenance Specialist to join our team at Wheeling Linen Service, Inc. As a key member of our maintenance team, you will be responsible for performing scheduled preventative maintenance programs, working with other associates to accomplish goals, and maintaining safety and cleanliness standards.ResponsibilitiesPerform...

  • Grant Specialist

    1 month ago

    Wheeling, West Virginia, United States Youth Services System Full time

    Job Summary:The Grant Specialist is a key member of the Administrative Team at Youth Services System, responsible for working closely with the CEO and CFO to forecast agency programmatic and capital needs that align with our strategic plan and state/national trends and best practices. This role involves performing state and federal grant research, writing,...

  • Cardiac Catheterization Specialist

    1 month ago

    Wheeling, West Virginia, United States Cross Country Allied Full time

    Cross Country Allied is seeking a highly skilled Cardiac Catheterization Specialist for a travel assignment in a dynamic healthcare environment. Job SummaryThis is a unique opportunity to work as a Traveling Electrophysiology Technologist, assisting with catheterization of the heart and other electrophysiology procedures. Key ResponsibilitiesPrepare and...

  • University Catalog Support Specialist

    2 weeks ago

    Wheeling, United States National Louis University Full time

    University Catalog Support SpecialistID 2024-1449Job LocationsUS-IL-WheelingCategory OtherPosition Type Staff (Full-Time)OverviewWho We Are: National Louis is a 135+ year old university that has been grounded in the values of innovation, access, excellence, and equity from its inception. As an institution, we believe in providing access to educational...

  • Home Care Specialist

    2 days ago

    Wheeling, West Virginia, United States HCAOA Full time

    We are seeking a skilled Home Care Specialist to join our dynamic care team at Right at Home, providing clinical expertise in-home. This rewarding role allows you to make a difference in the lives of others by helping people stay in the comfort of their own homes.About the JobCompetitive hourly rate: $10.50-$13.50Flexible scheduling to suit your needsPromote...

  • Nurse Specialist

    4 weeks ago

    Wheeling, West Virginia, United States White Glove Placement Full time

    Job SummaryWe are seeking a skilled Registered Nurse to join our team as a Telemetry/PCU Nurse Specialist. This is a 13-week travel assignment with a competitive weekly pay and a comprehensive benefits package.ResponsibilitiesProvide high-quality patient care in a Telemetry/PCU settingCollaborate with the healthcare team to develop and implement...

  • Security and Maintenance Specialist

    1 month ago

    Wheeling, West Virginia, United States Wheeling Linen Service, Inc. Full time

    Job DescriptionWe are seeking a reliable and detail-oriented individual to fill the role of Security and Maintenance Specialist at Wheeling Linen Service, Inc.This position is responsible for ensuring the security and cleanliness of our facility during evening and nighttime hours. The ideal candidate will have excellent communication skills, be able to work...

  • Data Entry Specialist

    2 weeks ago

    Wheeling, United States Treasured Memories Full time

    About Us:Treasured Memories is a family-owned agency located in Wheeling, WV.  Our team is dedicated to helping families preplan their funeral arrangements. We are looking for a detail-oriented Data Entry Specialist to join our team. If you’re someone who takes pride in your work, is skilled in handling large volumes of data, and thrives in a dynamic...

  • Youth Support Specialist

    5 days ago

    Wheeling, West Virginia, United States Crittenton Services, Inc. Full time

    Company OverviewCrittenton Services, Inc. is a leading provider of residential care services for young females. Our mission is to empower individuals to achieve their full potential and become productive members of society. Salary$14.00 to $15.00 per hour (dependent on experience) Job DescriptionWe are seeking a dedicated and compassionate Youth Support...

  • Cardiac Catheterization Lab Specialist

    4 weeks ago

    Wheeling, WV, United States Emerald Health Services Full time

    Epic Travel Staffing is seeking a skilled Cardiac Catheterization Lab Specialist for a 13-week assignment. This position requires a WV license, 2 years of experience, and Cardiac Catheterization Lab experience. The ideal candidate will have ARRT and BLS certifications. Key Responsibilities: Provide high-quality patient care in a Cardiac Catheterization Lab...